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Onboard the Phelophepa Train of Hope Part 1

In a previous post, third year optometry student Samantha Davidson wrote on the outset of her trip to South Africa volunteering on board the Phelophepa Train of Hope. In the first of two parts she chronicles her experience treating over 1,500 people in the space of two weeks.

Arriving in Vryburg

Phelophepa train crew – opticians and translators

Outdoor eye tests

Including myself, there were 10 optometry students volunteering aboard the train. Myself and 3 others were from Glasgow and 6 were from the University of the Free State. All the other students on the train were from universities in South Africa so we were the only foreign students on the train. Throughout the trip we became good friends, helping each other out and sharing knowledge and skills with each other that would help aid the precision and speed of our routines. There were 4 test rooms inside the train and 6 testing stations outside, we all alternated between working on and off the train.

All children were tested inside since the noise and distraction outside would have been too much of a distraction. Whist testing on the train our routine was adapted to be as efficient as possible to maximise the number of patients examined. Only the patient’s main complaint was addressed, refraction and ophthalmoscopy were completed throughout the eye exam, making it a lot more concise than the comprehensive eye exam you would usually experience here at home. We were seeing so many patients a day that it was hard to keep track, but I would estimate that in total we saw around 1500 patients across 10 days.

Glasses were available only in certain prescriptions.

Samantha treating residents of Vryburg onboard the phelophepa train.

Tools of the trade

There was a set range of glasses and prescription lenses available in the lab on the train. This meant that you wouldn’t be able to give the exact prescription that the patient required. The equipment we had on the train wasn’t entirely complete so making do and adapting to what was available was a struggle but we quickly became able to make the most of what we had. The first station we worked at was in the town of Vryburg. It took us 10 hours on a bus to reach the train from Johannesburg and we were picking up pharmacy, dental, nursing and psychology students along the way.

Travelling on the train, the landscape around us was very flat. Unlike Cape Town, the area around Johannesburg is renowned for having a lack of mountains and hills.

Land around Johannesburg is renowned for being very flat.

The train set up as a clinic

When we arrived we were shown to our compartments, there were 3 of us in a very small room but we made it work and came to appreciate what we had. It may have been small, but the patients were so desperate to be seen that they started queuing at 6pm the night before. Some were so desperate of being seen, they slept outside the train the night before to ensure they got an appointment in the morning. You may think that South Africa would be warm but whilst it may be summer in the UK, in this part of the world it is winter and during the night the temperature would drop dramatically.

My favourite patient from my time in Vryburg was an old lady who had cataracts in both her eyes, one of her eyes was beyond correction by glasses but she was not yet at the stage where she needed referred for cataract surgery. To start off with she struggled to see the biggest ‘E’ on the chart, this quite often disheartened patients, however after doing refraction she was able to see a long way down the chart. So often, I found, you are left feeling helpless when none of the train’s services are able to help someone whose vision is past saving or even helped by glasses, but the smile on her face and her excitement when she was able to read down the chart made my trip. She was shouting ‘E, E, E, E…’ with so much enthusiasm and vigour that people started to crowd round and see what all the fuss was about.

Another happy patient!

Come back next week as Samantha continues to talk about her experiences in South Africa, as the Phelophepa Train takes her to Delareyville.